EHR Software Industry User Report

Capterra pioneered the business software connection industry 15 years ago. Our
goal is to bring together the right software with the right healthcare team.

To do this, we seek to understand medical software buyers' and vendors' needs. Which is why we surveyed
buyers to get an integrated picture of just how people are finding, buying, and using Electronic Health
Records (EHR) software. We asked about who uses the software, what kind of software they use, what
features they use and don't use, want and don't want, and how software has impacted their practice.

We hope the results in this EHR software
report provide valuable insights regardless of what side of the healthcare industry you fall on—buyer,
user, or vendor.

If you find any part of it helpful, please share it with your colleagues. And if you think of any
follow-up questions, please let us know so we can include them in our next survey.

Key Takeaways

EHR software had the biggest positive impact on patient safety, records
security, and time spent finding and updating records, with twice as many reporting their EHR had a
significant improvement as slight improvement.

Avg EHR buyer spends $117,672 per year, $31,710 more than they expected.Tweet ThisPeople
spend, on average, $117,672 per year on EHR software, which is $31,710 more than they expected to spend.

Table of Contents

Overview of the EHR Software Industry

The market for electronic medical records and health records (EMR)
Market for EHR grew to $24.9 billion in 2014.Tweet Thisgrew
to $24.9 billion in 2014 and the market is predicted to rise to $35.2 billion by 2019. One health
information-technology contract alone, for the Pentagon, could
ultimately
be worth more than $10.5 billion, spread over its 18-year life.

About Buying

We asked users about the EHR software buying process. Their answers provide
insight for others looking to plan an EHR purchase, and for vendors looking to help buyers make the
software search as painless as possible.

How long have you been using your current EHR software?

That most respondents (61%) have been using their software 1-5 years makes sense given that the federal
government released “Meaningful Use” standards in 2010, and then gave physicians who wish to be eligible
for payments through Medicare and Medicaid five years to start meaningfully using electronic records
before penalties
hit.Most EHR users have been using their software 1-5 years.Tweet This

Were you using a different EHR system before purchasing your current software?

Most respondents are first-generation EHR users (almost 2/3rds) which, again, makes sense given the
government's use of incentive payments in the last few years to encourage medical professionals to
purchase EHR
software.2/3 of EHR users are still using their first EHR system.Tweet This

Why did you switch software?

Most people who switched EHR software did so because they wanted features their existing software did not
have. The second most commonly cited reason is that the software was no longer supported. This may be
because the expensive implementation of an EMR makes switching costs high, so people use their software
for longer than the vendor keeps updating it.Most people switch EHRs to take advantage of new features.Tweet This

How long in months did you spend searching for your EHR software (from research to final
purchase)?

Respondents did not expect to spend much time shopping for EHR software. The majority, 57% thought they
would spend under six months to find the perfect system.

For the most part, people's estimates for how much time they'd need to spend looking for EHR software
were accurate. 56% of respondents ended up spending six months or less searching for an EMR.

How many options did you demo before making your final purchasing decision?

A plurality of people (41%) only demoed two options before making a purchase. This lack of thorough
testing is surprising given how expensive most EMR purchases are. Perhaps it illustrates just how busy
most medical professionals are that they can't devote much time to learning about more than a couple EMR
options. It indicates an opportunity for vendors, however, who can be assured their chances of making a
sale increase greatly if they can get a buyer to the demo stage.
Surprising that people only demo 2 EHRs on average since it's such an expensive purchase.Tweet This

How long (from installation to full adoption) did it take to implement your EHR software?

People's estimates for how much time they'd need to spend implementing EHR software tended to be
optimistic at the top and pessimistic at the bottom, with 64% assuming they'd be up and running in fewer
than six months. The people who guessed in the middle were most accurate (59% actually were up and
running in under six months).

How much did you expect to spend (annually) for your EHR software and how much did you actually
spend?

People spent significantly more money than they expected to on EHR software. On average, they spent 37%
more annually than they expected to, amounting to an additional $31,710 a year.
People spent 37% more money than they expected to on EHR software.Tweet This

What factors most impacted your purchasing decision?

People considered functionality to be the highest priority when choosing EHR software. Ease of use was a
close second.
People considered functionality to be the highest priority when choosing EHR software.Tweet ThisGiven
how important a tool you work with everyday to make life and death decisions is, it's understandable these
are the primary considerations of respondents. Price was a distant third in importance, likely because of
how expensive EMRs are known to be. After that, support, implementation training, company reputation, and
software popularity were ordered most to least important to buyers.

Who We Asked

A high percentage of respondents who use EHR software do not describe their role
as physician, nurse, or even administrator (over a third, 36%, chose “Other” to describe their role).

What is your role?

This may be because in healthcare people whose roles relate to nursing but are not registered nurses do
not describe themselves as nurses, and because support and office staff who may have administrative roles
are not officially “hospital administrators.”

Which best describes the type of practice you work in?

As EHRs are used mostly by non-physicians and are most useful at scale, it makes sense that hospitals are
overrepresented among EHR users at 45% of the total.
45% of EHR users work in hospitalsTweet ThisClinics
and private practices make up another 32%, while specialty offices are the least, at 13%.

Which revenue band best describes the size of your organization?

Statista
predicts
that by 2015, total revenues of general private medical and surgical hospitals in the United States will
reach approximately $813 billion U.S. dollars. The most common revenue band for organizations using EHR
software is $1-5 million.

How many healthcare providers use your EHR software?

Answers clustered at the top and bottom, with most respondents working in a setting with more than 1,000
healthcare provider EHR users, but then the second most common answer was 2-9 users.

Considering the expense of buying and setting up EHR software, the high number of clinics with a small
user base is somewhat surprising and could be indicative of Meaningful Use incentives pushing smaller
providers into getting EHR.

How many total users access your EHR software?

Again, most respondents work in a healthcare setting with more than 1,000 total EHR users, but here the
second most common answer was 10-49 users. This indicates that there are a lot of people who aren't
physicians using EHR software (likely admin and office support staff).

What EHR People Use

Which EHR software are you currently using?

Epic, the most popular among our respondents, is ninth on our previous list. eClinicalWorks, our top
vendor according to past research, is in the middle of the pack here. Also interesting to note is the
concentration of EMRs used by respondents. The top six vendors have fully 54% of the
market.The top six EHR vendors own fully 54% of the market.Tweet This

Is your EHR web-based/hosted, or is it on-premise/installed locally?

By a small margin, most of our respondents use installed EHR software (56% to 44%). It appears that users
are slightly behind the industry-wide trend toward web-based software. Looking at
our EHR software directory, 155 are
web-based, 79 are installed, and many allow some combination of the two.

Installation type by length of software use.

Are people who have been using the same software longer more likely to be using installed software? There
is a slight positive correlation between length of use and deployment method (so, kind of).

Software Features

The top five most requested features are voice recognition, mobile
integration/app, 3M/other medical dictionary, telemedicine capabilities, and marketing functionality.

EHR features respondents wish they had.

The top five most requested features are voice recognition, mobile integration/app, 3M/other medical
dictionary, telemedicine capabilities, and marketing functionality.

Physicians, nurses, and admins want slightly different things from their EHR software, however.
Physicians, nurses, and admins want different things from their EHRs.Tweet This

EHR feature requests by role.

Physicians listed telemedicine capabilities and voice recognition as equally most important. They were
least interested in the ability to submit billing/claims electronically, E/M coding advice, e-prescribing,
and appointment booking.

Not surprisingly, nurses and admins listed voice recognition as the most important EHR feature. Perhaps
because they need to be in many different places at once, nurses listed mobile integration/app as their
second most sought feature. For admins, they wanted a 3M or other dictionary second-most, and marketing
functionality third-most.
Nurses and admins listed voice recognition as their most important EHR feature.Tweet This

We asked respondents more detailed questions on how they used their EHR features. Here's how usage broke
down:

Have it but don't use it.

More than twice as many people have the ability to submit billing and claims electronically and mobile
integration/app as actually do so.

Want it but don't know if they have it.

Although voice recognition was one of the most sought features among nurses and admins, the majority of
respondents are not sure whether their EHR software has this feature. Same for nurses wanting mobile apps
or integrations, but not knowing whether it's available to them. And although admins very much want a 3M
or other medical dictionary, nearly as many didn't even know if they had the feature as reported having
it.

This lack of awareness around desireable software points to a general lack of effective software
training.

A shocking number of respondents did not know whether their EHR software was ONC certified, more than
knew their software had the feature. The majority of users didn't know whether their software offered ROI
metrics, which may point to the fact that the majority of users are not responsible for ROI calculations.
E/M coding advice was similar, though slightly more people knew their software had the feature.

For telemedicine capability, slightly more users were unsure whether their software had the feature then
knew they had it. Slightly more than half of respondents who had access to telemedicine capability use it.
Almost no one who doesn't have it wants it.

Someone else uses it.

Only about half of respondents who had access to E/M coding advice reported using it. Same for Meaningful
Use certification, marketing functionality, and e-prescribing.

These numbers indicate not so much that the features don't get used, but rather that the individual
respondents don't use these software features themselves.

Most used EHR features.

Physician scheduling is a highly used feature, as is CPT search and patient reminders and alerts. A
patient portal is also highly used, and almost no one who doesn't have CPT search or a patient portal
wants one. Nearly everyone has and uses appointment booking and specialty-specific chart templates.

Software Impact

People are quite happy with their EHR software, and sky-high satisfaction rates
belie reports of an industry that provides subpar products.

How satisfied are you with your current EHR software?

The majority of users (70%) are satisfied or very satisfied with their EHR software, with another quarter
(23%) coming in at neutral. More users are very satisfied than are dissatisfied or very dissatisfied (19%
vs. 7%).
The majority of EHR users (70%) are satisfied with their software.Tweet This

Why are you unsatisfied with your current software?

Of the few that are dissatisfied or very dissatisfied, the most commonly cited reason was that their
software lacked certain features. The features respondents most often said they do not have and want were
voice recognition, 3M or other medical dictionary, and mobile app/integration.

The second most often cited reason was that the software is hard to use. Together these answers comprise
89% of dissatisfied responses.

How much impact has your EHR software had on the following?

For every area, most respondents reported that their EHR software had made a significant improvement.

EHR software had the biggest positive impact on patient safety, records security, and time spent finding
and updating records. Twice as many respondents reported their EHR had a significant improvement vs. just
a slight improvement in these areas.

Results between slight and significant improvement were closer for number of data errors made by nurses
and physicians, patient communication and collaboration, and practice profitability.

But, again, this may say more about the respondents than the software, since many of them may not be
familiar with how many data errors nurses and physicians make, how well the practice communicates and
collaborates with patients, or practice profitability. It may be for this reason that more respondents
answered “not sure” about these areas than patient safety, records security, and time spent finding and
updating records.

Going Forward

EHR software is not without its detractors. Pittsburgh Cardiologist Dean Kross
studies healthcare IT. He claims EHR software has been unable to improve overall outcomes or reduce costs
in the private sector despite a track record spanning more than a decade with complete freedom from
oversight.

Another huge problem is that most EHR software is not web-based and doesn't play well with other software
systems, making it difficult to achieve a chief goal of EHR software, which is making health records easy
to share across healthcare settings.

Yet, for all the reported problems, we found users are mostly very happy with their software, and see it
as having positively contributed to some really important key performance indicators, including patient
safety, records security, and time spent finding and updating records.

There are, of course, areas with tremendous potential for improvement. User training will help close the
information gap between the features users want and whether or not their software offers these
features.

Pricing transparency will help clinics and hospitals better budget for software, closing the $31,710 gap
between what buyers expect to spend and what they end up spending.

These and other changes will be exciting to track over the coming years.

Methodology

Capterra collected the data in this EHR software report through a 22-question survey of current
Electronic Medical Record/Electronic Health Record software users. It was conducted online over the course
of a one week period and received responses from 400 healthcare professionals in the United States.

Thank you

Thanks so much for reading the EHR software survey report! This has been a project of the
Capterra Medical Blog, a place for
people to learn how to use technology to improve outcomes, increase efficiency, and overall advance the
field of medicine.

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About the Author

Cathy Reisenwitz

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Cathy Reisenwitz writes about medical software and technology at Capterra. Her writing has appeared in
The Week, Forbes, the Chicago Tribune, The Daily Beast, VICE Motherboard, Reason magazine, Talking
Points Memo, and other publications. She has been quoted by the New York Times Magazine and has been a
columnist at Bitcoin Magazine. Her media appearances include Fox News and Al Jazeera America. If you're
a medical software company looking for more exposure, email Cathy at cathy@capterra.com. To read more of
her thoughts, follow her on Twitter.